Road Traffic Accident Victims Research Articles

Head Injuries in Fatal Road Traffic Accidents in Northern Districts of Bangladesh

Objective: To analyze the autopsy findings in the cases of fatal head injuries due to road traffic accidents. Study Design : Retrospective study Place and duration of study: This study was conducted at the Rangpur Medical College morgue among victims of road traffic accidents (RTA) during the period of July 2014 to June 2016. It was conducted to ascertain the patterns of fatal head injuries due to road traffic accidents as documented during autopsies performed at Rangpur Medical College during (July 2014 to June 2016) the two years. Material & Methods: Road traffic accident are the major causes of death worldwide. Head injuries is the single most common cause of mortality in road traffic accidents; head injuries being the most vulnerable part of the body. Total74 victims were taken from the road traffic accidents and died due to head injury. Aim of the study to find out the patterns of head injuries, their age and site distribution of different type of fractures. Results: The cases were seen more in the male victims (87.84%) as compared to female (12.16%). Present study showed that the place of occurrence of road traffic accident was more in the urban areas (77.03%) as compared to rural areas (22.97%). No one of the threewheeler riders was wearing helmets at the time of accidents. We observed subdural hemorrhage (SDH) in 63.83% followed by sub arachnoid hemorrhage (SAH) in 27.66% intracranial hemorrhage (ICH) 6.38% and least was extradural hemorrhage (EDH) 2.13% in twowheeler riders. while in three-wheeler riders SDH in 51.85% followed by SAH in 29.63% ICH in 11.11% and least was EDH in 7.41% in cases where skull fracture occurred. Most of the accident occurred at night. Conclusion: Head injury is one of the important causes of death in road traffic accidents. Most of the deaths occur on spot before any life support can be given to these subjects. The pattern of skull fractures observed in this study was quite comparable to other studies. It indicates that road traffic accidents lead to similar kinds of fatal head injuries throughout the world. J Shaheed Suhrawardy Med Coll 2021; 13(1): 75-79

The system of organizing the provision of medical care to victims in traffic accidents on federal highways in regions of Russia with low population density

Relevance. Road traffic injuries are one of the leading non-natural causes of death in the world. The principles of organizing the provision of medical care to victims of road traffic accidents (RTA) should be adapted to the resource capabilities of regional health care systems, as well as the distribution of the resident population across the territory.Intention: To develop and substantiate the principles of a system for organizing the provision of medical care to RTA victims on federal highways in Russian regions with a low average population density.Methodology. The results of our own, domestic and foreign scientific research were reviewed, along with regulatory legal documents on the organization of medical care for RTA victims in various conditions. Articles published in 1990–2021 were selected for analysis. Information sources were searched for using specialized scientific search engines (eLibrary, PubMed, Scopus) with the keywords: “traffic accident”, “traffic injury”, “polytrauma”, “federal highway”, “injured”, “hospital period “. System analysis was used to determine the shortcomings of the existing system of providing medical care to victims of road accidents that occurred on federal highways in the territories of Russian subjects with a low population density. Organizational experiments were used to substantiate and develop measures, the implementation of which will improve the efficiency of providing first aid and medical care to victims of road accidents on federal highways in Russian regions with a low population density.Results and Discussion. A system for organizing the provision of medical care to victims of road accidents on federal highways in the regions of the Russian Federation with a low density of the population in the pre-hospital and hospital periods has been developed and justified; it consists of 4 principles and their organizational measures.Conclusion. The implementation of the model and the principles of the developed system proposed by the author will reduce negative health consequences associated with road traffic injuries on federal highways in Russian regions with low population density.

Comparison of mortality prediction models for road traffic accidents: an ensemble technique for imbalanced data

BackgroundInjuries caused by RTA are classified under the International Classification of Diseases-10 as ‘S00-T99’ and represent imbalanced samples with a mortality rate of only 1.2% among all RTA victims. To predict the characteristics of external causes of road traffic accident (RTA) injuries and mortality, we compared performances based on differences in the correction and classification techniques for imbalanced samples.MethodsThe present study extracted and utilized data spanning over a 5-year period (2013–2017) from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS), a national level survey conducted by the Korea Disease Control and Prevention Agency, A total of eight variables were used in the prediction, including patient, accident, and injury/disease characteristics. As the data was imbalanced, a sample consisting of only severe injuries was constructed and compared against the total sample. Considering the characteristics of the samples, preprocessing was performed in the study. The samples were standardized first, considering that they contained many variables with different units. Among the ensemble techniques for classification, the present study utilized Random Forest, Extra-Trees, and XGBoost. Four different over- and under-sampling techniques were used to compare the performance of algorithms using “accuracy”, “precision”, “recall”, “F1”, and “MCC”.ResultsThe results showed that among the prediction techniques, XGBoost had the best performance. While the synthetic minority oversampling technique (SMOTE), a type of over-sampling, also demonstrated a certain level of performance, under-sampling was the most superior. Overall, prediction by the XGBoost model with samples using SMOTE produced the best results.ConclusionThis study presented the results of an empirical comparison of the validity of sampling techniques and classification algorithms that affect the accuracy of imbalanced samples by combining two techniques. The findings could be used as reference data in classification analyses of imbalanced data in the medical field.

An Epidemiological Study of Road Traffic Accident Cases Attending a Tertiary Care Hospital

Introduction: Road traffic accidents are a major global health problem. Incidence of road traffic accidents can be minimized by applying safety measures and following strict traffic rules and regulations.
 Aims: The main purpose of our study was to find out the socio-demographic profile of the victims involved in road traffic accidents and to provide epidemiological data.
 Methods: This is a hospital based, cross sectional study with victims of road traffic accidents attending to Nepalgunj Medical College, Kohalpur,a tertiary care center. Consecutive patients of road traffic accidents attending emergency department or admitted in wards (surgery, orthopedic or neurosurgery) were taken and information of injury pertaining to epidemiological factors and demographic profile along with time of occurrence of accident, type of vehicle involved, the pattern of injury, site of accident and part of body involved was collected on a pre-designed proforma.
 Results: Total patients enrolled in the study were 410.Majority of victims were young with age group of 10-19 years(18.5%). By gender male were more affected than female (67.8% versus 32.2%).Incident was more among married couple (61%). Majority belongs to Hindu by religion (96.1%). Regarding educational level majority have attained school level education (46.8%). By occupation majority were students (36.1%) followed by private employee (16.6%). Most of road traffic accidents were happened during summer season (65.4%). Regarding time most accidents were in between 6 PM10PM. Major site of accident was highway (63.4%). Among vehicle involved 4 wheelers were more common (65.4%).Head, neck and face region was found mostly injured in this study (33.2%). Most common type of injury was abrasion (30.7%) then followed by laceration (26.3%).
 Conclusion: Road traffic accidents can be minimized and it’s fatal consequences also preventable by strict enforcement of traffic rules and applying safety measures.

Pattern of Orthopedic Injuries Related to Road Traffic Accidents Among Patients Managed at the Emergency Department in Black Lion Hospital, Addis Ababa, Ethiopia, 2021.

BackgroundStudies showed that each year people lose their life on the road and many people are disabled. The majority of this disability was caused by orthopedic injury related to road traffic accidents. However, in the context of Ethiopia, studies ascribed to orthopedic injuries related to road traffic accidents are limited. The study aimed to assess the pattern of orthopedic injuries related to road traffic accidents among patients managed at the emergency department of Black Lion Hospital.MethodsAn institutional-based cross-sectional study was conducted on 354 victims of road traffic accidents with orthopedic injuries who were visiting the Emergency department of Black Lion Hospital. Patient charts were selected by systematic random sampling technique and the data was entered into Epi-data version 4.4.2.2 and exported to the static package for social science window version 26, and descriptive statistics were used for analysis.ResultsThe study reveals that males were mostly injured persons (71.7%) with the age group of 13–24 were the most injured. Passenger car accounts 36.3% of causes of injury followed by motorbikes (27.4%) and lower limbs were the most common anatomic site of injuries (47.9). Of all injury types, a fracture is the most common one with 71.1%, especially lower limb fracture (42.1%). More than half victims (59.5%) had open wounds, and almost half of the study subjects (51.8%) experience Road traffic accidents while they are crossing or walking along the way.ConclusionOrthopedic injuries related to road traffic accidents are the main cause of death and disability in many individuals, especially in reproductive age groups. Therefore, policy-makers should be aware of different patterns of orthopedic injuries associated with a victim of road traffic accidents to have an appropriate and sustainable capacity to manage the orthopedic injuries.

Evaluation of results of minimally invasive plating Osteosynthesis (MIPO) technique in the treatment of fractures of distal tibia

Background: Fractures are the commonest injury among the victims of non-fatal road traffic accidents, and it commonly involves the bones of the lower extremity. This can be due to the interplay of gravitational force and velocity of the vehicle at the time of accidents. Tibial fractures are the most common type of long bone fractures and are the most common open fractures. Based on the fracture location in the bone, distal tibia fractures have the second highest incidence of all tibia fractures. The relatively tenuous blood supply, subcutaneous location of the tibia, mechanism of injury, and use of certain treatment methods contribute to a relatively high incidence of post traumatic complications following tibia fractures. These complex open fractures which are produced by high energy forces, threaten to pose a challenge to orthopaedic surgeons. Considerable advances in the methods and concepts of internal fixation along with newer innovations in implants help to meet such challenging tasks.Aim: To evaluate the efficacy, functional and radiological outcome of distal third tibia fractures managed by minimally invasive plate osteosynthesis.Methods: This is a prospective study, period from December 2019 to May 2021, and a minimum of 30 cases with fractures of distal tibia were attended in the casualty and OPD and were admitted in this hospital and were evaluated clinically and radio graphically.Results: All fractures healed without the need of any secondary procedures. There was no noticeable mal- alignment or non-union. Functional outcome was good to excellent in all patients. Average time to bony union was 24 weeks.Conclusions: From our study it is further proved that the effectiveness of minimally invasive plate osteosynthesis is a good and safe technique for treatment of distal tibial fractures without intra- articular comminution providing fracture healing, rapid functional recovery, along with avoidance of major complications.

Diagnosis of Concussion in a Victim of Road Traffic Accident

Cerebral concussion is a minor and reversible functional abnormality and due its relatively minor nature it usually goes undetected and underreported. Despite increased knowledge and awareness of concussion and its long-term sequelae, effective measures of diagnosis, prognosis and treatment still appear to be deficient.

Profile of Road Traffic Accident Victims Admitted at Bhayangkara Pusdik Sabhara Porong Hospital

Background: Traffic accidents are a health problem in forensic medicine that often occurs in society and needs attention, mainly because it is still a major problem in implementing road transportation in Indonesia. Traffic accidents increase yearly along with the increasing number of road users and the ease of ownership of transportation facilities. In 2012, the death toll from traffic accidents in Indonesia was 29,544, with a case fatality rate (CFR) of 14.95%. In 2013, the victims died from traffic accidents, namely 26,416 people, with a case fatality rate (CFR) of 15.98%. In 2014 the victims died due to traffic accidents, namely 28,297 people with a case fatality rate (CFR), traffic accidents of 17.16%. In 2015 the victim died due to traffic accidents, namely 26,185 people with a case fatality rate (CFR) traffic accident of 15.37%. Objective: To describe profile of road traffic accident victims admitted at Bhayangkara Pusdik Sabhara Porong Hospital in 2021-2022. Methods: This research is a retrospective descriptive study. The research sample used was medical record data of traffic accident patients examined at Bhayangkara Pusdik Sabhara Porong Hospital in 2021-2022. Result: The incidence of traffic accidents at Bhayangkara Pusdik Sabhara Porong Hospital can be described as follows; 71.4% are male. Thirteen people (37.1%) are aged 15-29 and based on where the most occurrences on the Surabaya-Malang highway, there are ten people (28.6%), and then based on the time of the incident where the most happened at 12.00 – 18.00, namely 12 people (34.2%), based on the position of the victim where the most were as motorists. Motorcycles have as many as 26 people (74.3%), and based on the type of injury where the most were abrasions is 24 people (40%). Conclusion: The description of the incidence of traffic accidents at the Bhayangkara Pusdik Sabhara Porong Hospital in 2021-2022 is mainly experienced by men of productive age. It occurred on the Surabaya-Malang highway, which has a heavy traffic flow; the time of the incident was during working hours, position the victim was a motorcyclist, and the most common types of injuries were blunt force trauma.

Analisis Kualitas Pelayanan Terhadap Klaimen PT Jasa Raharja Cabang Sumatera Utara

This study aims to determine the quality of service provided by PT Jasa Raharja, North Sumatra Branch to the claimants or customers who are victims of road traffic accidents. The method used in this study is a qualitative method, which produces research in words and based on the results obtained in the field. This research was conducted at the North Sumatra Branch of the Jasa Raharja Office, which is located at Jl. Jendral Gatot Subroto No. 142 Medan. Types and sources of data used in this study are: Primary data and secondary data. Data collection techniques were carried out by means of observation, interviews and literature study. This study shows the results of the factors that hinder the quality of service, namely: many people do not understand the scope of guarantees borne by Jasa Raharja, communication to partners is not evenly distributed and external obstacles such as correspondence. The factor of the company is the lack of human resources that result in less effective and timely.

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study.

PurposePost-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals.Materials and MethodsAn institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05.ResultsOut of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06).ConclusionThe prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.

Organ Donation and the Medicolegal Aspects

Context: In India, the majority of brain-dead organ donors are victims of road traffic accidents, thereby making them entities in medicolegal cases (MLC). This places an additional burden and complicates the organ donation process, as an inquest must be conducted by the police station closest to the accident spot before the possibility of organ donation is considered. Following organ retrieval and donation, a postmortem is required before the body is handed back to the police. These procedures cause delays in the organ donation process and subsequently in families receiving the body of their loved ones. The problem is compounded by the fact that there are variations in the inquest and postmortem procedures in different states. Aim: The study aims to comprehensively enumerate the medicolegal protocols followed by the states having an active deceased organ donation program. Design and Methods: A survey, using a structured questionnaire, was conducted among the senior Transplant Coordinators (key stakeholders in the organ donation process) of eight states. Their experiences handling MLC and the state protocols adhered to were captured. Results: It was found that there were differences in protocols followed by the states with respect to medicolegal organ donation cases. Significant variations were observed in the police inquest and postmortem procedures. A need for training of the police personnel in the medicolegal aspects of the organ donation process is evident from the survey responses. Conclusions: The undue delays lead to difficulties in completing the donation and also cause distress among the family members who have said yes to organ donation despite their grief. The study recommends the need for uniformity in protocols to ease pain points in this program. This is of paramount importance in instances of interstate-organ donation cases.

Road Traffic Accidents in Port Harcourt, Rivers State: Pattern of Injuries That Caused Death, Risk Factors, Anatomical Sites Affected, and Autopsy Findings

Background: Road traffic accident (RTA) is one of the commonest causes of death among the healthy population and it’s among the leading cause of death due to human errors. Globally, it has contributed significantly to reducing the workforce as well as increasing the family expenditure on preventable health conditions. It is grossly underreported with no clear data on annual death reports, especially in most developing countries. Objectives: To determine the rate of death from a head injury due to road traffic accidents, risk factors; the commonly injured anatomical regions and immediate cause of death from autopsy examination of victims. Methods: This was a prospective longitudinal study in which 86 victims with CORONER FORM D were sampled recruited for the study. Primary data were obtained using the Crash Report Form (CRF) from the Federal Road Safety Corps, oral interviews from deceased relatives and security personnel who brought the victims, and subsequently, Coroner form D was used to obtain /record the findings of autopsy examination. Data was analysed using Statistical Product and Service Solutions (SPSS) version 25.0 (Armonk, NY). Results: The rate of death from a head injury due to RTA in Port Harcourt was 48.84%. The mean age of victims examined at autopsy was 28.61 ± 9.22 with a modal age group of 20-29. Majority of the victims were males [52(65.82%)], passengers [36(42%)], had superficial autopsy [32(37.20%)], multiple injuries [40 (46.51%)]. The commonest cause of immediate fatality was head injury (48.8%) followed by haemorrhage and shock 31(36.1%). Over speeding was the most common human risk factor (50%), followed by sleep/fatigue (10%). The commonest mechanical and environmental risk factors identified were brake failure and burst tyres (8%), and potholes (6%) respectively. Conclusion: The commonest cause of death among victims of RTA in Port Harcourt, Rivers State, Nigeria is head injury. Over speeding, sleep/fatigue, brake failure and burst tyres and pot holes are the risk factors for RTA in Port Harcourt. Measures targeted at controlling these risk factors would help reduce morbidity and mortalities associated with RTA.

Clinical and Médico-Legal Aspect of Traumatism Bucco-Dental Injuries in Yaounde-Cameroon

The Main Objective: of the study was to describe the socio-demographic, clinical, medico-legal, therapeutic and prognostic characteristics of traumatic oral lesions in patients presenting to health facilities in Yaoundé. Methods: We conducted a descriptive, prospective, cross-sectional study for 7 months during 2021, in consenting patients, with traumatic dental lesions in four secondary and tertiary health facilities in Yaoundé. The data was collected, processed, and analyzed using IBM SPSS version 23.0 software® for Windows®. Results: Of the 129 patients included, 70.54% were male. The median age was 29.57±14.73 years. Single people accounted for 67.44%. People working in the private sector and those with a secondary education represented 48.84% and 44.96% respectively. The emergency department of the selected hospitals received 51.00% of the patients with traumatic oral injuries. Clinically, patients with head and neck injuries and those with isolated oral trauma had 72.09% and 22.48% respectively. Of 183 traumatized teeth, 79.24% were incisors. About 56.59% of the patients were hospitalised, while 75.20% underwent radiological examination. In total, 73.64% had undergone a surgical procedure. About 54.26% of the cases were victims of road traffic accidents (MVA). From a medico-legal point of view, 75.97% of the patients suffered an involuntary trauma. The average total temporary disability was 21.97 days ± 17.47 days (0-45 days). The 5-level pain scale was used and 37.21% of our population had a pain grade of 5. Only 16.28% (21) of the cases received a documented forensic assessment. Of the participants, 13.18% (17) expressed their intention to seek legal compensation for the trauma they suffered. Almost 76.74% (99) of the cases had a combination of functional impotence and cosmetic damage as a result of the traumatic injury. A total of 68.97% (60) of the cases had received a TIW≥30 days for involuntary trauma while, 68.00% (17) received a TIW<8 days for voluntary trauma Conclusion: The oral trauma profile in Yaoundé is similar to many studies worldwide. Documented forensic assessment of damage

Improving Lagos State emergency medical services by analysing road traffic accident data, response time, and efficient allocation of ambulances

BackgroundEmergency medical services (EMS) play a critical role in the response to road traffic accidents (RTAs) by providing critical prehospital care to RTA victims, and thus helping to reduce the severity of injuries and casualties from RTAs. Analysing the efficiency of such systems and optimising the service (often with insufficient resources) would be highly beneficial to inform operating guidelines. In this study, we aimed to assess the ambulance utilisation rate for RTAs and provide insights about the system's efficiency and utilisation metrics in Lagos State, Nigeria. MethodsWe received hospital capacity information (type of hospital [eg, tertiary] and number of beds, nurses, operating rooms, and so on) from hospital survey data in Lagos. Additionally, we received RTA-specific intervention forms from the Lagos State Ambulance Service. With the limited amount of historical data, we highlighted methods to estimate the system parameters (eg, arrival rate, service rate, and so on) of RTA victims at various hospitals in Lagos. We also developed a parametric model and applied approximate dynamic programming approach for ambulance dispatch and location optimisation with a fixed number of base stations. Furthermore, our routing approach was accompanied by directions from OpenRouteService and queue analysis to determine the most appropriate hospital near an RTA for the EMS systems in Lagos. FindingsUsing patient-queue based wait-time analysis, we found that in over 80% of cases, one of the nearest three hospitals was the most appropriate recommendation for patient delivery. This exponentially decays with the next closest hospitals. Additionally, we found that optimising the ambulance relocation method, where the ambulance returns to a base selected by our model as opposed to its dedicated base or a random base, can reduce the average response time of the EMS system by 8%, or 3·5 min (from 41 min to 38 min). InterpretationAppropriate placement of mobile resources (ie, ambulances, health-care booths, and so on) can help to lower the response time of EMS systems in addressing RTAs. Similarly, optimal routing of patients to the most well prepared and nearby hospitals would significantly increase the system's efficacy and improve health outcomes. Our findings can provide valuable insight into this and further inform resource allocation and guidelines for health systems, by identifying those hospitals that have the highest burden of RTA victims and those that provide the most efficient care in a resource-limited setting. FundingNational Institutes of Health (1R21TW010991–01A1).

Implementasi Undang-Undang Nomor 34 Tahun 1964 tentang Dana Pertanggungan Wajib Kecelakaan Lalu Lintas Jalan di Kabupaten Aceh Barat

Implementation of Law Number 34 of 1964 concerning Compulsory Funds for Road Traffic Accidents in Meulaboh City. This study aims to inform, Implementation of Law no. 34 of 1964 concerning the Compulsory Fund for Road Traffic Accidents in West Aceh Regency. In order to achieve this goal, this research uses a data collection technique through observation, interviews, and documentation. The data that has been found from the research results are then obtained using a qualitative study in order to find out the implementation of Law no. 34 of 1964 concerning the Compulsory Fund for Road Traffic Accidents in West Aceh Regency. The results of this study ensure that: 1) The implementation process of providing compensation funds to PT. The services of Raharja Meulaboh Branch for victims of road traffic accidents in Meulaboh City are in accordance with the Act. 2)Process of PT. The service of Raharja Meulaboh Branch in providing compensation funds to victims of road traffic accidents in the city of Meulaboh is quite good. However, in this process, it has been found that the victim's/heir's ignorance is that in fact the victim or heir is guaranteed by the social security that has been regulated by law. Therefore, due to the ignorance of the victim or heir that there will be social security, the right or expiration of the right to obtain compensation funds due to the accident of road traffic transportation has resulted. This shows because PT. Jasa Raharja Meulaboh Branch is still not socializing about the provision of compensation funds to the community, especially in the interior of the village and so far there are still many people who do not understand the process of providing compensation funds to PT. Jasa Raharja Meulaboh Branch

Addressing the association between driving with an expired vehicle inspection certificate and injury severity after a crash

Objectives The aim of this study was to quantify the association between driving a vehicle with an expired vehicle inspection certificate (DEVIC) and the severity of injuries sustained by drivers involved in collisions. Methods A cohort study was designed to compare the incidence of minor injuries, major injuries, and deaths between DEVIC and non-DEVIC drivers involved in collisions. We selected all 51,305 non-responsible drivers (i.e., drivers who did not commit an error or infraction) involved in clean collisions (those in which only one driver in multivehicle collisions committed a traffic infraction or error) from the population of drivers of four-wheeled motor vehicles involved in crashes recorded in the National Register for Road Traffic Accident Victims in Spain from 2014 to 2017. Results DEVIC was not related with a greater severity of drivers’ injuries. The adjusted estimates for the association between DEVIC and major injuries or death yielded an odds ratio of 0.91 (0.66–1.25), compared to no injuries or minor injuries, and a relative risk ratio of 0.90 (0.65–1.24) compared to no injuries. Conclusions Although we have not found an association between DEVIC and drivers’ injury severity, the study limitations does not allow us to discard the usefulness of periodic vehicle inspection in reducing the risk of more severe injury among drivers involved in road crashes.

TREATMENT COST OF ROAD TRAFFIC ACCIDENT IN VICTIMS WITH SURGICAL INTERVENTION AT DANANG HOSPITAL

Objective: To analyze treatment cost of road traffic accident in victims with surgical interventions at Danang hospital on perspective of payers and to identify some factors affecting out of pocket cost of victims and their households. Materials and Method: This is a cross sectional and descriptive study. 193 victims or their relatives were interviewed directly and medical records and invoices were reviewed to collect data of their treatment costs at hospital. Multivariate linear regression model was used to identify factors affecting out of pocket cost of participants. Results: Economic total cost of road traffic accident victims who suffered surgical intervention at Danang Hospital was 28,475 thousand VND, in which medical direct cost, non-medical direct cost and indirect cost were accounting for 69.8%, 13.6% and 16.6%, respectively. Cost for surgery, medication and hospital bed accounted for the highest proportions of medical direct cost with 33.3%; 25.5% and 18%, respectively. Out-of pocket average total cost was 9,154 thousand VND. Factors influenced their out of pocket cost including participating in health insurance (B= -9,865,109; 95% CI: -12,960,181 - -6,770,038), number of inpatient days (B= 882,125; 95% CI: 780,081- 984,169) and being students (B= 4,081,835; 95% CI: 883,645- 7,280,025). Conclusion: Treatment cost for road traffic accident victims with surgery is economic burden to them and their household. Key words: road traffic accident, economic cost, economic burden, ability to pay, victim.

Судово-фармацевтичні дослідження щодо впливу ліків на безпеку, життя та здоров’я учасників дорожнього руху в межах організації фармацевтичної справи, технології ліків, фармацевтичного та медичного права в Україні

Актуальність. У всьому світі дорожньо-транспортні пригоди (ДТП) під впливом лікарських засобів (ЛЗ) є однією з головних причин травмувань, смертності серед учасників дорожнього руху. Безпека руху уявляє собою систему, яка включає наступні складові: людина – стан здоров’я людини – вживання небезпечних ліків різних класифікаційно-правових груп (КПГ) – побічні реакції ліків – транспортний засіб – шлях. Частка дорожньо-транспортних пригод під впливом ліків становить понад 75%, вони є й найбільш суспільно небезпечними, тому що мають тяжкі наслідки, спричиняють невиправну шкоду здоров’ю та смерть потерпілих. Мета дослідження: проаналізувати здобутки судово-фармацевтичних досліджень в Україні щодо впливу ЛЗ на безпеку, життя та здоров’я учасників дорожнього руху в межах організації фармацевтичної справи, технології ліків та фармацевтичного і медичного права в ретроспективному аспекті. Матеріали та методи. Матеріалами імперативного дослідження стали законодавчі, нормативно-правові документи; матеріали становлення наукової школи судової фармації; наукові публікації за темою статті; Інтернет-ресурси, джерела наукової літератури. Для досягнення поставленої мети було застосовано методи судово-фармацевтичного, нормативно-правового, документального, бібліографічного, порівняльного, історичного та графічного аналізу. Результати. Проаналізовано досвід країн світу щодо профілактики та попередження дорожньо-транспортних пригод під впливом ліків. Причини, умови виникнення та наслідки ДТП носять багатофакторний характер і пов’язані з постраждалими (водій-пішохід), транспортним засобом, дорогою, вживанням психоактивних ЛЗ. Розроблено систему організаційно-регуляторних та попереджувальних заходів з надання першої медикаментозної допомоги потерпілим від ДТП. Показано, що існує необхідність проведення науково-обґрунтованих організаційно-правових, клініко-фармакологічних, судово-фармацевтичних та соціально-економічних досліджень щодо причинних зв’язків між побічними реакціями внаслідок вживання ЛЗ різних КПГ, безпекою руху та виникненням ДТП. Вперше в Україні було запропоновано математичну модель щодо встановлення впливу психоактивних ЛЗ на стан водія при керуванні транспортним засобом у залежності від обчислення шляху зупинки автомобіля відповідно до обраної швидкості та зниження реакції водія. Досліджено структуру ДТП, скоєних під впливом психоактивних лікарських препаратів. Висновки. Запропоновано класифікацію медичних аптечок для надання першої медикаментозної допомоги потерпілим при ДТП, яка дозволила обґрунтувати необхідність удосконалення їх як за якісним, так й кількісним складом у залежності від типу транспортного засобу й імовірності виникнення ДТП з тяжкими наслідками. Запропоновано рекомендації стосовно забезпечення інформації про можливість отримання медичної допомоги та систему сигнально-викличного зв’язку на шляхах, маркірування упаковок психоактивних ЛЗ спеціальною позначкою у вигляді червоного трикутника. Доведено про необхідність подальших судово-фармацевтичних досліджень.

The development of first medical care support to victims of road traffic accidents: The publications review

The medical and demographic losses because of road traffic accidents continue to be significant in most of economically developed and developing countries. The national strategies of reducing medical and demographic losses include two groups of measures, depending on object of exposure: (1) targeted to decreasing risk of road traffic accidents and (2) targeted to timely and adequate medical care support of victims. Beyond this classification are activities targeted to developing and improving in participants of road traffic skills of first self-care and mutual assistance. The availability of mentioned skills is important for saving lives and preventing permanent disability of victims of road traffic accidents.

Jejuno-Ileal Ruptures after Blunt Abdominal Trauma at the Teaching Hospital of Bouake

Objective: The aim of this study is to determine the causes, pattern, management, and outcome of jejunal-ileal rupture following blunt abdominal trauma at the teaching Hospital of Bouake. Methods: The study included 27 patients who underwent laparotomy for jejunoileal injuries from blunt abdominal trauma at the Teaching Hospital of Bouake over a period of 14 years from January 2007 to December 2020. A retrospective study was conducted and the patients were analyzed with respect to patient demographics data, cause, injury mechanisms, presentation, anatomical distribution, diagnostic methods, associated injuries, treatment and outcomes. Results: During the 14 year period from 2007 to 2020, 27 patients with blunt small bowel injuries were treated at our Teaching Hospital. That is 2.9% of all blunt abdominal trauma. Male to female ratio was 4.4:1 and the average age was 26.3 years (range: 15 and 50 years). The majority (66.7% 18 cases) were Victims of road traffic accident. Median delay between injury and arrival at hospital for these patients was 10.1 hours (range: 1 - 72 h). A single intestinal injury was present in 22 patients, while 5 patients suffered from 2 injuries. There were 32 perforations of the small intestine in 27 patients with two perforations being transection. All perforations were located on the antimesenteric border of the intestine. Out of the 32 jejuno-ileal ruptures 18 were located on the jejunum while 14 were located on the ileum. Associated intra-abdominal injuries were present in 6 patients and nineteen associated extra-abdominal injuries were present in 10 (70.4%) patients. A one-stage therapeutic strategy was performed in 20 cases (74.1%) and a two-stage strategy was performed in seven cases (25.9%). Intestinal continuity was restored 93.8 days later (range 60 and 140 days). The average length of hospital stay of the operated patients was 11.4 days. The operative morbidity was 25.9%. Conclusion: Jejuno-ileal ruptures are rare and characterized by a delay in management. An early diagnosis could improve the vital prognosis of the patients.